If this is your first visit, be sure to
check out the FAQ by clicking the
link above. You may have to register
before you can post: click the register link above to proceed. To start viewing messages,
select the forum that you want to visit from the selection below.

Sobering comments from neurologist today...

I reported in the SM/CM thread on our MRI results, which were NOT good. We have a tough battle ahead. But not here to get into those details. Wanted to share this for discussion. When we were talking with neurologist before the MRI, he said he could not REMEMBER when he scanned a Cavalier that did not have at least some chiari malformation.... Including Cavs who were there for other symptoms or illnesses that required MRI. He thought it was at least 2 years since he had seen clear MRI. Now he did say that he sees much smaller % with major syrinx formation but that he kind of assumed CM in all Cavaliers, especially under age 7. This floored my husband, but I thought this was very consistent with statistics we have seen reported here. what do you think?

Out of curiosity...I know what happens when a dog has SM...but what happens when a dog has CM? Is that painful to them? Do they go on medications or have surgery? Does CM lead to SM?

If all of our dogs were to (for argument sake) have CM...would we all need to be "doing something" like medication, etc. or is CM just something they have with no treatments attached?

Sorry...still learning all of this!

It depends really- my boy has CM with pain and he is on medication for it. He has a diuretic which works well for his pain

However to any one else looking in they wouldn't think he has ANYTHING wrong with hm!!! He is still very very active and loves life and has more energy than most dogs I know BUT when we are quiet at home his scratching is beyond excessive and he has facial pain- which I know as the white of his eyes go very red and his eyes water alot and he paws at his face!

So I for one wouldn't be to quick to say that just because they are active, they don't suffer.

I am pleased that he is on medication and I will let you know at the end of the year whether it has progressed or not!!!

Karen

Ruby - my stunning soul mate who defies the odds every dayCharlie- my angel at heart and devil at play

Aside from Riley, my 3 with just CM without SM are all asymptomatic. I had MRIs done on two of them for something totally unrelated to SM so the CM was an incidental finding and for Oz it was to help me determine if what he had was EFS (episodic falling syndrome) or SM. I know they're not alike, but his first episode occurred right after Riley was diagnosed with SM so all I could think of was SM. His MRI was the day after her surgery - talk about stress!!! All his MRI showed was CM and he is totally asymptomatic of either EFS or SM at this time.

Cavaliers have the highest serotonin levels of any breed this is why they have such happy personalities and waggy tails - sadly it also means that they are very good at disguising pain.

Also when the adrenaline levels are high, when they are excited, out for walks, running, agility etc, they are not so aware of the pain - my severely affected dog could run and even clear a 5ft fence if he wanted to get to me!! My vet could not believe it..

Originally posted by Karlin:

25% of cavaliers with SM symptoms have CM only, not SM

That's according to a research sample of clinically affected, scanned cavaliers in the new research paper out from Clare Rusbridge et al. This is the same one Rod notes in an earlier thread about 76% of these dogs also had further syrinxes lower than the C5 vertebrae (and thus dogs with syrinxes are likely to be worse than a mini scan will show).

Abstract below, but this excerpt from the paper interested me as it suggests a hitherto unexpectedly large number of dogs with clinical signs of SM (all dogs in the study had clinical signs)-- one in four!!! -- have CM only -- which suggests people with such dogs really need to be treating it AS WITH SM, not attributing the problem to some other likely cause (something vets also need to recognise):

The median age of the dogs included in the study was 5 years (1.2–10.8 years). CM was present in all patients. None of the dogs showed compressive craniocervical pathology other than CM. There was no evidence of SM on MRI in 12/49 (25%) dogs. In all dogs with MRI evidence of SM (37/49; 75%), SM was present within the C1–C4 region (Figs. 2 and 3). Of those dogs with SM within C1– C4 region, 76% (28/37) also had SM within the C5–T1 and/ or T2–L2 regions, but only 49% (18/37) had SM within the L3–L7 region.

Abstract

Chiari-like malformation (CM) and syringomyelia (SM) is an important disease complex in the Cavalier King Charles Spaniel (CKCS) but data about the anatomical distribution of SM along the spinal cord are lacking in veterinary medicine. The objective of this study was to define the anatomic distribution of SM in CKCS clinically affected by CM/SM. Magnetic resonance imaging (MRI) of the brain and the entire spinal cord of 49 dogs was performed and different morphological parameters compared.

Syrinx formation was present in the C1–C4 region and in other parts of the spinal cord. The maximal dorsoventral syrinx size can occur in any region of the spinal cord and the total syrinx size was positively correlated with age. Seventy-six per cent of CKCS with a cranial cervical syrinx also have a syrinx affect- ing more caudal spinal cord regions. MRI restricted to the cervical region may underestimate the extent of SM and the severity of the disease
process in the majority of dogs.

There are several dogs on the forum who have very severe symptoms ***just*** from CM.

Sadly too many people are not aware of what to look for and many dogs suffer needlessly.

Briian, it's great to hear that Rosie is doing so well but can I remind you that you were the one who was so worried about her:

Yesterday Rosie yelped twice then came straight over and sat by me for comfort, then later on she had trouble sitting bending down and scratching with her back foot under her chin and she was very wary of twisting her body when she moved .

You reported she was chewing her feet and scooting excessively, despite her anal glands being clear - this led to her being MRI'd. In the past you have posted about her yelping "for no reason" and the vet not being able to find anything, and her being clingy at those times [many of us who have lived with symptomatic dogs report this with our dogs - they are very clingy when they are not feeling so good]

Cavaliers have the highest serotonin levels of any breed this is why they have such happy personalities and waggy tails - sadly it also means that they are very good at disguising pain.

Nicki,

Can you give citations for the above statement? I've heard this once before but I've never found the basis for this statement. If it is from the research in heart valve cell structure by Chris Orton and Mark Oyama cited below, I don't know if one can extrapolate to the statement above. Have you read research that makes that extrapolation? I've looked and can't find anything, and I'd be very interested to read anything on this.